A Closer Look at ‘Common Ground’ for Collaborative Health Delivery

An elusive but essential ingredient for success in collaborative health activities is establishing “common ground” among a diversity of individual and group actors. Existing research on common ground (CG) has for the most part focused on it as a one-time event, neglecting the multiple activities needed to develop CG over time.

Professor Craig Kuziemsky of the Telfer School and Professor Tracey O’Sullivan of the Interdisciplinary School of Health Sciences are of the view that CG in collaboration has to be seen as more than just a conversation, shared information or a shared model. Their study in the March issue of Social Science and Medicine presents CG as a dynamic process that in the authors’ words “drives collaboration in health communities in order to generate actions and solutions to problems.”

“There is a strong need, as our study and others have highlighted, for people to build enough shared knowledge to communicate, coordinate, and collabore as part of group activities,” explained professor Kuziemsky, Director of the M.Sc. in Health Systems Program at the Telfer School. One of the key issues with CG: its many components do not evolve in sync. Loss of face to face interaction can make developing collaboration a challenge. Collaboration has to start with a basic foundation, “People need to become comfortable with one another through engagement and awareness about people, processes and resources.” 

Professors Kuziemsky and O’Sullivan studied CG development in three Canadian communities in Nova Scotia, Ontario, and Alberta between October 2010 and March 2011 through a project on capacity building for disaster management. It involved focus group discussions with participants from multiple sectors, including emergency management professionals, firefighters, police, paramedics, social work and community liaisons and other essential services. The study identified three distinct stages of CG focused on establishing the governance structure for conversation, networking and exchange (coordinative stage); elaboration of rules and protocols (cooperative stage); and finally use of those protocols in problem solving (collaborative stage).

It is the first study that has looked extensively at the relationship between micro (individual) and macro (group) CG development. Understanding what motivates individuals to collaborate and what they need to acquire from collaboration is necessary to form CG at a group level, explained Kuziemsky. While CG is a group activity, a group is the sum of several unique individuals. An individual's desire to maintain autonomy and not share information and resources is a barrier to developing CG at the group level. “CG development is very much a negotiation between individual and group needs.”

By identifying specific categories of individual and group CG development, the research provides a way of targeting collaborative outcomes. This perspective is similar to the concept of social learning that looks at the differences between individual and group learning and how to design instructional artifacts (e.g. information resources, learning tools) to integrate the two learning types, noted  Kuziemsky. “Indeed, future work could incorporate theories from social learning, and other domains, to expand the individual-group aspect of our research.”

Crucial implications for leadership also emerged from the work. The findings highlight that leadership is more than just directing people; it also involves maintaining sustainability by keeping people together and engaged during the “peaks and troughs” of common ground development.